FFR is a well-validated clinical tool, used to assess the functional significance of intermediate or ambiguous coronary artery stenosis(1). Due to the advantages of hemodynamic assessment and guided coronary revascularization of culprit lesions FFR is considered as a gold standard technique for the evaluation of coronary stenosis provoking ischemia(2). Although FFR was originally described in the 1990s(3-5), it has become a clinical interest recently as various landmark studies proved its effectiveness in lesion-specific revascularization with favorable outcomes(6-8). FFR is defined as the ratio of maximum coronary blood flow in the presence of coronary stenosis to the maximum coronary blood flow in the absence of coronary stenosis under the
…show more content…
And also, if a functionally significant coronary stenosis as defined by FFR less than 0.75, had undergone a PCI the probability of death or suffering an acute myocardial infarction was five times higher in the next five years than a similar angiographic severe lesion which is non-significant by FFR and treated medically(7). At two-year follow-up of the FAME study, in patients with multi-vessel coronary artery disease who underwent FFR-guided PCI with drug-eluting stents had a significant reduction in mortality and myocardial infarction compared to angiography-guided PCI group(12). Additionally, the number of stents per patient were less in the FFR-guided PCI group. The FAME 2 trial demonstrated a significantly lower rate of urgent need for revascularization in FFR-guided PCI group than in the optimal medical therapy group. The recruitment of patients in this study was terminated prematurely due to the significant difference in primary endpoint events among the two study groups(6). Earlier studies have demonstrated that coronary artery bypass artery grafting(CABG) is preferred over PCI in patients with the 3-vessel disease. The comparison of FFR-guided PCI with second-generation drug-eluting stents to CABG in patients with the 3-vessel disease is currently being investigated by the FAME 3
And also, if a functionally significant coronary stenosis as defined by FFR less than 0.75, had undergone a PCI the probability of death or suffering an acute myocardial infarction was five times higher in the next five years than a similar angiographic severe lesion which is non-significant by FFR and treated medically(7). At two-year follow-up of the FAME study, in patients with multi-vessel coronary artery disease who underwent FFR-guided PCI with drug-eluting stents had a significant reduction in mortality and myocardial infarction compared to angiography-guided PCI group(12). Additionally, the number of stents per patient were less in the FFR-guided PCI group. The FAME 2 trial demonstrated a significantly lower rate of urgent need for revascularization in FFR-guided PCI group than in the optimal medical therapy group. The recruitment of patients in this study was terminated prematurely due to the significant difference in primary endpoint events among the two study groups(6). Earlier studies have demonstrated that coronary artery bypass artery grafting(CABG) is preferred over PCI in patients with the 3-vessel disease. The comparison of FFR-guided PCI with second-generation drug-eluting stents to CABG in patients with the 3-vessel disease is currently being investigated by the FAME 3